A 59-year-old man with diabetes presented with a 15-year history of intermittent fetid left-sided otorrhea and hearing loss without tinnitus or dizziness. Otoscopic examination revealed a subtotal perforation associated with an attic perforation that was filled with desquamative skin debris. An incidental finding was noted on a computed tomogram of the temporal bone on the opposite side that the patient had brought with him (Figure 1). An osteolytic lesion had expanded the internal and external cortical bone of the vertical portion of the mandible.